From correlates to causes: can quasi-experimental studies and statistical innovations bring us closer to identifying the causes of antisocial behavior?

Longitudinal, epidemiological studies have identified robust risk factors for youth antisocial behavior, including harsh and coercive discipline, maltreatment, smoking during pregnancy, divorce, teen parenthood, peer deviance, parental psychopathology, and social disadvantage. Nevertheless, because this literature is largely based on observational studies, it remains unclear whether these risk factors have truly causal effects. Identifying causal risk factors for antisocial behavior would be informative for intervention efforts and for studies that test whether individuals are differentially susceptible to risk exposures. In this article, we identify the challenges to causal inference posed by observational studies and describe quasi-experimental methods and statistical innovations that may move researchers beyond discussions of risk factors to allow for stronger causal inference. We then review studies that used these methods, and we evaluate whether robust risk factors identified from observational studies are likely to play a causal role in the emergence and development of youth antisocial behavior. There is evidence of causal effects for most of the risk factors we review. However, these effects are typically smaller than those reported in observational studies, suggesting that familial confounding, social selection, and misidentification might also explain some of the association between risk exposures and antisocial behavior. For some risk factors (e.g., smoking during pregnancy, parent alcohol problems), the evidence is weak that they have environmentally mediated effects on youth antisocial behavior. We discuss the implications of these findings for intervention efforts to reduce antisocial behavior and for basic research on the etiology and course of antisocial behavior.     

Psychoanalytic perspectives on music: an intersection on the oral and aural road

This paper is organized around two ideas. The first invites the reader to consider the importance of music in emotional life, suggesting that for some people, music can have profound, deep, and transformative effects, both in loosening defenses and in deepening the psychoanalytic experience. The second idea is that analysis of the formal properties of music have both specific and overdetermined meanings that share elements with psychoanalytic principles. I suggest that, if the verbal analysis of dreams paves a royal road to the unconscious, the formal properties of music provide an aural road to the same destination. Two clinical vignettes and scenes from Verdi's opera Otello are used to illustrate these interrelated ideas.     

Physical maltreatment victim to antisocial child: evidence of an environmentally mediated process

The well-documented finding that child physical maltreatment predicts later antisocial behavior has at least 2 explanations: (a). Physical maltreatment causes antisocial behavior, and (b). genetic factors transmitted from parents to children influence the likelihood that parents will be abusive and that children will engage in antisocial behavior. The authors tested these hypotheses in the representative Environmental-Risk cohort of 1116 twin pairs and their families, who were assessed when the twins were 5 and 7 years old. Mothers reported on children's experience of physical maltreatment, and mothers and teachers reported on children's antisocial behavior. The findings support the hypothesis that physical maltreatment plays a causal role in the development of children's antisocial behavior and that preventing maltreatment can prevent its violent sequelae.     

Factors Influencing Clinical Correlates of Chronic Traumatic Encephalopathy (CTE): a Review

Chronic traumatic encephalopathy (CTE) is a neuropathologically defined disease reportedly linked to a history of repetitive brain trauma. As such, retired collision sport athletes are likely at heightened risk for developing CTE. Researchers have described distinct pathological features of CTE as well a wide range of clinical symptom presentations, recently termed traumatic encephalopathy syndrome (TES). These clinical symptoms are highly variable, non-specific to individuals described as having CTE pathology in case reports, and are often associated with many other factors. This review describes the cognitive, emotional, and behavioral changes associated with 1) developmental and demographic factors, 2) neurodevelopmental disorders, 3) normal aging, 4) adjusting to retirement, 5) drug and alcohol abuse, 6) surgeries and anesthesia, and 7) sleep difficulties, as well as the relationship between these factors and risk for developing dementia-related neurodegenerative disease. We discuss why some professional athletes may be particularly susceptible to many of these effects and the importance of choosing appropriate controls groups when designing research protocols. We conclude that these factors should be considered as modifiers predominantly of the clinical outcomes associated with repetitive brain trauma within a broader biopsychosocial framework when interpreting and attributing symptom development, though also note potential effects on neuropathological outcomes. Importantly, this could have significant treatment implications for improving quality of life.     

Posttraumatic Stress Symptoms and Trajectories in Child Sexual Abuse Victims: An Analysis of Sex Differences Using the National Survey of Child and Adolescent Well-Being

Very few studies have prospectively examined sex differences in posttraumatic stress symptoms and symptom trajectories in youth victimized by childhood sexual abuse. This study addresses that question in a relatively large sample of children, drawn from the National Survey of Child and Adolescent Well-Being, who were between the ages of 8–16 years and who were reported to Child Protective Services for alleged sexual abuse. Sex differences were examined using t tests, logistic regression, and latent trajectory modeling. Results revealed that there were not sex differences in victims’ posttraumatic stress symptoms or trajectories. Whereas caseworkers substantiated girls’ abuse at higher rates than boys’ abuse and rated girls significantly higher than boys on level of harm, there were not sex differences in three more objective measures of abuse severity characteristics. Overall, higher caseworker ratings of harm predicted higher initial posttraumatic stress symptom levels, and substantiation status predicted shallower decreases in trauma symptoms over time. Implications for theory and intervention are discussed.     

Chaotic homes and children's disruptive behavior: a longitudinal cross-lagged twin study

Chaotic home lives are correlated with behavior problems in children. In the study reported here, we tested whether there was a cross-lagged relation between children's experience of chaos and their disruptive behaviors (conduct problems and hyperactivity-inattention). Using genetically informative models, we then tested for the first time whether the influence of household chaos on disruptive behavior was environmentally mediated and whether genetic influences on children's disruptive behaviors accounted for the heritability of household chaos. We measured children's perceptions of household chaos and parents' ratings of children's disruptive behavior at ages 9 and 12 in a sample of 6,286 twin pairs from the Twins Early Development Study (TEDS). There was a phenotypic cross-lagged relation between children's experiences of household chaos and their disruptive behavior. In genetically informative models, we found that the effect of household chaos on subsequent disruptive behavior was environmentally mediated. However, genetic influences on disruptive behavior did not explain why household chaos was heritable.     

Lead exposure and child maltreatment as models for how to conceptualize early-in-life risk factors for violence

Although rates of violent crime have been on the decline in the United States for the past two decades, young people—and particularly young men—continue to commit and fall victim to alarmingly high rates of violence. Effective prevention requires data on what the determinants of violence are and when in the life course they emerge. The goal of this review was to identify early-in-life risk factors for violence and to describe (a) who is most affected and (b) effect mechanisms. I focus on abuse and neglect and exposure to lead as risk factors for violence that disproportionately affect young children and that are likely to have causal effects on development. I conclude with future directions for research and intervention.     

The limits of child effects: evidence for genetically mediated child effects on corporal punishment but not on physical maltreatment

Research on child effects has demonstrated that children's difficult and coercive behavior provokes harsh discipline from adults. Using a genetically sensitive design, the authors tested the limits of child effects on adult behavior that ranged from the normative (corporal punishment) to the nonnormative (physical maltreatment). The sample was a 1994-1995 nationally representative birth cohort of 1,116 twins and their families who participated in the Environmental Risk Longitudinal Study. Results showed that environmental factors accounted for most of the variation in corporal punishment and physical maltreatment. However, corporal punishment was genetically mediated in part, and the genetic factors that influenced corporal punishment were largely the same as those that influenced children's antisocial behavior, suggesting a child effect. The authors conclude that risk factors for maltreatment are less likely to reside within the child and more likely to reside in characteristics that differ between families.     

Effects of the family environment: gene-environment interaction and passive gene-environment correlation

The classical twin study provides a useful resource for testing hypotheses about how the family environment influences children's development, including how genes can influence sensitivity to environmental effects. However, existing statistical models do not account for the possibility that children can inherit exposure to family environments (i.e., passive gene-environment correlation). The authors introduce a method to simultaneously estimate the effects of passive gene- environment correlation and gene- environment interaction and use it to investigate the relationship between chaos in the home and verbal ability in a large sample of 4-year-old twins.